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J Environ Manage ; 248: 109317, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31394474


Disaster risk reduction is a major concern of small island developing states. Measures to reduce risk should not only be based on the magnitude of physical hazard, but also on the exposure and vulnerability of communities. In this article, we examine flood risk management policies in the Caribbean island of Sint Maarten using coupled agent-based and flood models. The agent-based model is used to model actors' behaviour in relation to urban building development and policies that are designed to reduce flood hazard and communities' vulnerability and exposure. The policies considered in the model are a Beach Policy, a Building and Housing Ordinance, a Flood Zoning policy and hazard mitigation structural measures. The flood model is used to simulate coastal and pluvial floods on the island. Agent behaviour such as building new houses and implementing hazard reduction measures affect the flood model as these actions affect the rainfall-runoff process. The flood maps generated from the updated flood model simulations are then used to assess the impact and update agents' attributes and behaviour. The simulations results show that low-lying areas are populated, which increases the exposure, and the number of vulnerable houses is also high. Hence, out of the four policies, implementing hazard reduction measures is the most important. Reducing the flood hazard by widening existing drainage channels, constructing new ones and building dykes as coastal flood defence would reduce the hazard, hence reducing the number of flooded houses. As it affects all households on the island, the Building and Housing Ordinance is an important policy to reduce vulnerability. In general, the coupled model outputs can be used to inform policy decision making and provide insights to policymakers on the island.

Desastres , Inundações , Planejamento de Cidades , Gestão de Riscos , São Martinho (Países Baixos)
J Vector Borne Dis ; 55(2): 137-143, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30280712


Background & objectives: The first chikungunya (CHIK) epidemic in the Americas was reported in December 2013. Chikungunya virus (CHIKV) causes an acute febrile illness and is transmitted to humans by Aedes mosquitoes. Although earlier studies have described long-term clinical manifestations of CHIK patients infected with the East/Central/South African (ECSA) genotype, little is known about persistent manifestations in the Caribbean region, for which the Asian genotype is responsible. The objective of this study was to describe the presence of persisting clinical manifestations, specifically arthralgia, in CHIKV-infected patients on the Caribbean Island, Sint Maarten, 15 months after onset of the disease. Methods: This retrospective cohort study included confirmed CHIK patients that were recorded by the participating general practitioners (GPs) during the chikungunya outbreak in 2014 in Sint Maarten. Between March and July 2015, 15 months after the onset of disease, patients were interviewed via telephone about the presence, duration and impact of clinical CHIKV manifestations. Results: In total, 56 patients were interviewed (median age 47 yr), of which 30 (54%) were females. Out of the total interviewed patients, 52 (93%) reported arthralgia for the first three months after the disease onset, of which 23 (44%) patients reported to have persistent arthralgia, 15 months after the disease onset. Pain intensity of persistent arthralgia was perceived as mild in the majority of patients (n = 14; 60%), moderate in 7 (30%) patients and severe in 2 (9%) patients. During the acute phase of disease, most patients had to miss school or work (n = 39; 72%) due to clinical CHIKV manifestations and reported a negative impact on daily activities (n = 36; 57%). Interpretation & conclusion: Results suggested that persisting arthralgia is a frequent complication in CHIK patients included in the study. Future research on strain-specific clinical long-term manifestations and on their impact on daily life of patients, in the form of a comparative study between patients and controls, is recommended.

Artralgia/etiologia , Febre de Chikungunya/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artralgia/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya/genética , Vírus Chikungunya/isolamento & purificação , Vírus Chikungunya/fisiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , São Martinho (Países Baixos) , Adulto Jovem
Mar Pollut Bull ; 133: 442-447, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30041335


Here we investigate microplastics contamination on beaches of four islands of the Lesser Antilles (Anguilla, St. Barthélemy, St. Eustatius and St. Martin/Maarten). These islands are close to the North Atlantic subtropical gyre, which contains high levels of microplastics. On average 261 ±â€¯6 microplastics/kg of dry sand were found, with a maximum of 620 ±â€¯96 microplastics on Grandes Cayes, Saint Martin. The vast majority of these microplastics (>95%) were fibers. Levels of microplastics differed among islands, with significantly lower levels found in St. Eustatius compared to the other Islands. No difference in microplastic levels was found between windward and leeward beaches. Our research provides a detailed study on microplastics on beaches in the Lesser Antilles. These results are important in developing a deeper understanding of the extent of the microplastic challenge within the Caribbean region, a hotspot of biodiversity.

Plásticos/análise , Poluentes Químicos da Água/análise , Praias , Região do Caribe , Monitoramento Ambiental/métodos , Poluição Ambiental , São Martinho (Países Baixos)
Rev Panam Salud Publica ; 41: e61, 2017 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-28902274


This report describes the outbreak of chikungunya virus (CHIKV) in Sint Maarten, a constituent country of Kingdom of the Netherlands comprising the southern part of the Caribbean island of Saint Martin, from 22 December 2013 (first reported case) through 5 December 2014. The outbreak was first reported by the French overseas collectivity of Saint-Martin in the northern part of the island-the first site in the Americas to report autochthonous transmission of CHIKV. By 5 December 2014, Sint Maarten had reported a total of 658 cases-an overall attack rate of 1.76%. Actual prevalence may have been higher, as some cases may have been misdiagnosed as dengue. Fever and arthralgia affected 71% and 69% of reported cases respectively. Of the 390 laboratory-confirmed cases, 61% were female and the majority were 20-59 years old (mean: 42; range: 4-92). The spread of CHIKV to Sint Maarten was inevitable given the ease of movement of people, and the vector, island-wide. Continuing their history of collaboration, the French and Dutch parts of the island coordinated efforts for prevention and control of the disease. These included a formal agreement to exchange epidemiological information on a regular basis and provide alerts in a timely manner; collaboration among personnel through joint island-wide planning of mosquito control activities, especially along borders; notification of all island visitors, upon their arrival at airports and seaports, of preventative measures to avoid being bitten by mosquitoes; dissemination of educational materials to the public; and island-wide public awareness campaigns, particularly in densely populated areas, for both residents and visitors. The information provided in this report could help increase understanding of the epidemiological characteristics of CHIKV and guide other countries dealing with vector-borne epidemics.

Febre de Chikungunya/epidemiologia , Surtos de Doenças , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , São Martinho (Países Baixos)/epidemiologia , Fatores de Tempo , Adulto Jovem